[HN Gopher] Scientists Discover a Cause of Lupus, Possible Way t...
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       Scientists Discover a Cause of Lupus, Possible Way to Reverse It
        
       Author : adamredwoods
       Score  : 94 points
       Date   : 2024-07-10 21:24 UTC (1 hours ago)
        
 (HTM) web link (news.feinberg.northwestern.edu)
 (TXT) w3m dump (news.feinberg.northwestern.edu)
        
       | ipunchghosts wrote:
       | I wonder if any of these findings help us better understand
       | me/cfs.
        
         | galangalalgol wrote:
         | It has been my hope that the number of me/cfs cases would
         | finally drive enough research into autoimmune disorders in
         | general, that we might finally figure it out. It seems very
         | poorly understood from an outside perspective.
        
           | PaulKeeble wrote:
           | There is no funding and since Long Covid appeared the funding
           | for ME/CFS has completely vanished. If Long Covid ME like
           | illness is the same then ME/CFS is getting lots of research
           | right now, on the other hand if they turn out to be different
           | ME/CFS patients are getting completely ignored.
        
             | thenerdhead wrote:
             | Many ME experts are doing both. RECOVER is considering
             | adding ME/CFS arms to its huge clinical trial platform.
             | UCSF just added ME/CFS as a priority in their LIINC
             | program.
             | 
             | SARS-CoV-2 therapeutics won't work on both but immune cell
             | based ones may given they haven't been tested in either
             | yet.
             | 
             | Both suggest a root cause of persistent viral antigen. Time
             | will tell what works here.
        
         | PaulKeeble wrote:
         | Maybe but the immune dysfunction goes further in ME/CFS its not
         | just a problem of reduced CD4 and heightened CD8 (which are the
         | two cell types they seem to be talking about) its a wider set
         | of oddities that seem related to exhausted cells with not
         | enough energy stuck in "there is infection near by" operation
         | mode. It might help reduce symptoms that are caused by the
         | imbalance so it would certainly be worth a trial when they work
         | out the details.
        
       | BenFranklin100 wrote:
       | Autoimmune diseases, of which lupus is but one of many, are
       | essentially black boxes. It's proven extraordinarily difficult to
       | develop therapies in this area. As such, this is great news.
       | Hopefully this research will encourage pharmaceutical and biotech
       | companies to invest more resources into translating research
       | findings into effective therapies.
       | 
       | I haven't read the paper yet, so I can't comment on how this
       | discovery might generalize to other autoimmune diseases, but one
       | interesting bit about autoimmune diseases is that they tend to
       | run in packs. This is suggestive there may be underlying
       | mechanisms that are shared across autoimmune diseases.
        
         | atombender wrote:
         | The aryl hydrocarbon receptor (AhR), which is key to this
         | discovery, appears to be super relevant to psoriasis, another
         | autoimmune disease.
         | 
         | AhR has been known for a long time, but it seems it's been
         | somewhat mysterious until a series of recent breakthroughs. In
         | 2022, an AhR inhibitor called tapinarof, sold as VTAMA, was
         | launched, and has shown itself to be one of the most effective
         | treatments for psoriasis to date. It's also unique in that it
         | appears to have the ability to bring lasting remission. In the
         | main clinical trial, patients who used VTAMA for one year and
         | then stopped had a mean remission duration of 4 months until
         | their psoriasis returned. That is unheard of for any topical
         | medication used on psoriasis.
         | 
         | Blocking AhR has also shown promise in treating MS [1].
         | 
         | I haven't read the lupus paper, but often with papers like
         | these, the "cause" turns out not to be the actual origin, but
         | some cytokine or other protein that is more disease-specific
         | than current drug targets. This lupus discovery appears to
         | identify an imbalance that may be compensated for, but we still
         | don't know what triggers the imbalance in the first place.
         | 
         | In some cases diseases turn out to be a genetic fault, but my
         | money is on pathogens acting as the initial triggering event,
         | which then spins the immune system into a vicious cycle of
         | autoimmunity. In psoriasis we see this with strep bacteria, for
         | example, but the exact mechanisms are not well understood.
         | However, the mechanism that makes psoriasis chronic _has_ been
         | identified, a type of T-cell called a tissue-resident memory
         | (TRM) T-cell. This type of cell acts as a kind of biological
         | memory for infections.
         | 
         | [1] https://newsroom.uvahealth.com/2023/02/15/multiple-
         | sclerosis...
        
           | BenFranklin100 wrote:
           | Great comment, thanks. I'm looking forward to reading the
           | paper.
        
         | kylehotchkiss wrote:
         | I have a good feeling we're going to make a fairly big impact
         | on cancer in our lifetimes with mRNA and other new discoveries
         | in our lifetime. Autoimmune issues I'm feeling much less
         | confident about. It seems like so many of the therapies are
         | "turn down the immune system". I wish there was wider study
         | into autoimmune derived mental health complications too. Maybe
         | I'm totally wrong on this (and I'm very OK to be proven wrong)
         | but maybe there's something to find here.
        
       | trhway wrote:
       | On one side we have in this article :
       | 
       | " insufficient activation of a pathway controlled by the aryl
       | hydrocarbon receptor (AHR), which regulates cells' response to
       | environmental pollutants, bacteria or metabolites. Insufficient
       | activation of AHR results in too many disease-promoting immune
       | cells, called the T peripheral helper cells, that promote the
       | production of disease-causing autoantibodies.
       | 
       | To show this discovery can be leveraged for treatments, the
       | investigators returned the aryl hydrocarbon receptor-activating
       | molecules to blood samples from lupus patients. This seemed to
       | reprogram these lupus-causing cells into a cell called a Th22
       | cell that may promote wound healing from the damage caused by
       | this autoimmune disease.
       | 
       | "We found that if we either activate the AHR pathway with small
       | molecule activators or limit the pathologically excessive
       | interferon in the blood, we can reduce the number of these
       | disease-causing cells,"
       | 
       | On the other side quick search on AHR activation brings for
       | example cancer related stuff like this :
       | 
       | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10570930/
       | 
       | "AHR activation to promote tumor cell intrinsic malignant
       | properties and to suppress anti-tumor immune responses [14],
       | [17], [18]. Specifically, the AHR drives cancer cell migration,
       | invasion, and survival, regulates cell cycle progression and
       | promotes cancer stem cell characteristics [14], [19], [20], [21],
       | [22]. Simultaneously, it inhibits anti-tumor immunity "
       | 
       | Human body by its complexity and our lack of understanding of it
       | sometimes reminds the codebases i've worked on :)
       | 
       | In that rabbit hole of articles on AHR there is also :
       | 
       | https://www.nature.com/articles/s41423-020-00585-5
       | 
       | "The aryl hydrocarbon receptor and the gut-brain axis"
       | 
       | which in particular discusses what looks to me (i'm not a doctor)
       | like a connection/correlation : gut microbes -> AHR ->
       | glioblastoma.
        
         | elcritch wrote:
         | Both reactions make sense to me. Too much AHR activation
         | suppresses immune response leading to cancer proliferation due
         | immune cells not culling cancerous cells, but too little leads
         | to auto-immune conditions. It's definitely like a large sloppy
         | code base with lots of implicit overlaps and global effects.
        
       | beekaywhopper wrote:
       | script writers for House are shaking in their boots
        
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